Reforming the Military Health Care System

A number of military and veterans groups are expressing concern over a letter that Senator John McCain (R–AZ) has sent to members of the congressional Joint Select Committee on Deficit Reduction suggesting they adopt earlier proposals from a March report of the Congressional Budget Office (CBO) for scaling back military health care benefits and increasing fees.

These groups are right to be concerned, but Senator McCain’s underlying views about the growing costs of the military health care system cannot be ignored. The costs are growing too quickly.

The CBO proposals include prohibiting military retirees from participating in the TRICARE Prime program and increasing applicable fees. In all, the CBO proposals are estimated to save the Department of Defense over $100 billion over 10 years. Senator McCain wants these resources to go toward improving readiness.

Senator McCain’s concerns about the possibility that the military is weakening in terms of readiness are well founded. Defense budgets that are too small—and the toll imposed on the force by the operations in Afghanistan and Iraq—are significant. He is also right that reforming the military health care system can be a source of funds for improving readiness. The military and veterans groups are miscalculating if they assume that the status quo can be preserved.

Senator McCain, however, is wrong to look to the CBO’s approach for reforming the military health care system. Attempting to preserve the basic structure of the military health care system and achieve savings by reducing benefits and increasing fees within that structure will not be fair to military service members, retirees, and their dependents. A better approach is to look to systemic reforms of the military health care program.

On a gradual basis, military health care coverage programs under TRICARE should be converted from the existing defined-benefit structure to a defined-contribution structure. Under this approach, a portion of the reductions in benefits can be offset by increasing the level of basic pay provided to the troops. Additionally, military service members, retirees, and their dependents may be provided tax advantages they carry with them for the rest of their lives.

This systemic approach means avoiding “less of the same” under TRICARE for the military community, which for them quickly becomes a proposition of “all pain and no gain.” The alternative approach unavoidably imposes some pain, but it also provides opportunities to the military community for very valuable gains.

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Baker Spring is the F.M. Kirby Research Fellow in National Security Policy at The Heritage Foundation. He specializes in examining the threat of ballistic missiles from Third World countries and U.S. national security issues.

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As a retired Army Warrant Officer I am very concerned. I was laid off in April and could not afford BCBS under the Cobra program. When I looked for other programs, I was told that since I have a pre-existing condition (Thyroid Cancer) they will not insure me. I depend on Tricare Prime for Health Care solely. Loosing it would mean no health care for me, or extreme increases in costs, effectively putting me out on the street, because I depend on my retirement to pay my real estate taxes.

And what about all the miitary retirees who were promised free healthcare for life in exchange for making the military a career? We served our country with honor and dignity for over twenty years. During our careers, we made more self-sacrifices than could ever be enumerated here. The bottom line: we paid our part of the bargain with blood, sweat, and tears. We kept our word; Washington has not.

It is shameful. Washington has no desire to keep the promises it made to its veterans. Is this their method of saying, "Happy Veteran's Day"?

I have to agree with Charlie. The facts are this: Serving the military those who look at our service look at the medical as a benefit. However, it is not. Our medical is an entitlement. To those who served in the Vietnam War it was guaranteed to them. My father a Vietnam Air Force Veteran said these very words. I'm not surpised the notorious McCain has made his point known that he would like ot move money from those who have served and are battling the heathcare. Not many veterans would believe that for just a healthy male in his 40's without dependants can be expected to pay over $400 a month in out of pocket heath care costs. When that's more than a third of your total income it becomes a concern. However, I don't see Mr. McCain refusing his government paid check-up. However, he'll try and take from those who've lost it all.

As a veteran, now in private industry, I can look back at my pay and benefits in the military and know that they are excellent! The military (and all government entities) must have pay and benefits similar to that of private industry, because it is the taxes of those in private industry, and those companies, that are required to support the government. Getting a retirement check after 20 years that is guaranteed for the rest of ones life is truly exhorbitant when compared with the private sector. Now, on one hand, what the government has promised, it should fulfill, but it must stay with the times and never cease to ensure that its pay and benefits are similar to private industry. As a veteran, I know what it's like to serve 24/7, and to put your life on the line, but people all over America do that every day with their jobs, as I now do for my private sector job. I've also experienced first-hand the Tricare system on active duty that can be so wasteful. Now that I'm required to pay very large portions of my medical care, I am more careful about when I go in, and what tests I receive, even asking to speak with the Billing dept before proceeding, in order to know exact costs.

This the "quantitative easing" the democrats (communists) are pushing. There was no tricare until the clintons came to office. This is Hillary's baby that she created. Those of you on tricare for life, you'll have a big awakening when you turn 65. You'll be pushed out of tricare and put on medicaid. Military hospitals there after are giving you the service as a courtesy, which can stop at anytime. I find it distasteful that McCain even proposes cutting military retiree healthcare. Of course he's not worried, he has the special congressional healthcare for life package.

Breaking promises to those the military trained to fight is not a good policy. It might come back to haunt the government later when those highly trained retirees support unrest and a forceful change in government. Which is why homeland security wants to add vets and military retirees to the watch list, if they have not done so already.

Let's see? Obamacare is funded in part by reductions in Medicare to seniors, and increases in fees to seniors. Retirees from the military and social security recipients had their pay frozen for two years to help balance the budget. Now, Rino McCain, who's guaranteed a pension from the Senate and truly free healthcare for life, wants retirees to once again foot the bill for out-of-control spending. By a show of hands, how many think Congress will use the "savings" to improve active duty military life? I thought so…

I'm retired and a receipent of TriCare for Life. I don't mind making a small contribution even though I was promised full medical coverage. I think the amount you contribute should be comensurate with your rank at retirement. The thing that would turn me off big time, is to mix these funds raised by us with other congressional funds. Can Rino McCain and President O'bama guarentee this?

One correction: at 65, you go on Medicare as primary and TriCare-For-Life as secondary (backup) payer.

With all due respect and appreciation for his USN service and horrific POW captivity, I sincerely believe that Senator McCain has impaired judgement that is a direct result of his imprisonment in North Vietnam. The physical torture, psychological warfare, emotional deprivation, etc., he endured must have done irreparable damage to his person. How else do you explain and rationalize his support for McCain-Finegold Campaign Finance Reform, his dreadful performance during the 2008 presidential campaign, and this current initiative, to name but a few examples. Simply stated, the man is compromised.

The Federal budget problem is one of spending way too much, not insufficient revenue. For those of us who were honored and privileged to serve this great country and achieve career retirement, we've seen the gross fraud, waste, and abuse that are rampant throughout the Federal government structure and processes. There are many viable options for revenue generation and expense reduction at the Federal level – assets (idle land, vacant buildings, etc.) could be sold; entire departments and agencies could be jettisoned (Education, Energy, Fannie Mae, Freddie Mac, Commerce, etc.); Civil Service and political appointee salaries and benefits could be brought in line with those of their private sector counterparts;
the USPS could be privatized; etc.

I, too, was promised free medical care for life if I completed at least 20 years of honorable USAF service. And, I fully concur with the comments above regarding this proposal, along with what's occurred previously, constitutes a serious breach of contract and violation of a major commitment to all military retirees, current and future.

As with SS and Medicare, structural reforms are needed so that existing retirees, who built their life around a promise of benefits, are guaranteed those benefits under a defined-benefit system while active duty members paid more into the system under a sliding-scale, defined-contribution system.

It's a shame, though, that the benefits for the people who actually defended and defend our way of life is even on the table due to our federal government's inability to say no to everyone else who has not made those sacrifices and their ability to buy votes from the same in exchange for benefits.

If the military was as solid a voting block for the Democrats as are unions, then they would not have to worry about cuts in their benefits. I'd like to think that the GOP hesitates to cut the defense budget for security reasons and not political ones, but I'm sure it is a factor in their decisions.

Part 1: I separated from the Air Force in 2007 after almost 9 years of service and 3 post 9-11 deployments to Afghanistan, Kuwait, Saudi, Turkmenistan etc. Even though I will never see a dime of military healthcare or retirement benefits, I will not support fleecing our brave airmen, soldiers, sailors & marines who served 20+ years to bailout the federal government. If you want to “reform” the Military Health Care System for the new recruits coming in, so be it. Tell them up front before signing up and good luck recruiting……. For everyone else currently serving & retired- FULFILL THE PROMISE. Barely &frac12; of 1% of our citizens have the courage to stand up and protect our country. Providing basic retirement with healthcare benefits for our service members is the LEAST we can do. There are plenty of other areas in DOD where money can be saved. From reducing the Pentagon bureaucracy, to closing depots, to throwing out the DOD Acquisition Process and starting over- tens of billions can be saved each year. Can’t tell you how many weapons programs I’ve worked over the years that were literally paralyzed due to the bureaucratic indecision with untold millions of dollars wasted.

Part 2: Just look at the DOD acquisition process chart- it’s a recipe for disaster: http://www.lexingtoninstitute.org/library/resourc… Billions of $$$ people, billions…………. DOD actually has to hire consultants just to help navigate their own process- insane. I support many of your views, Heritage, but not this one. I survived more than 27 convoy missions in Afghanistan serving side by side with airmen soldiers, marines and sailors. I can tell you this- the risks & sacrifices paid by these men & women don’t compare to the amount of money it costs to provide them with decent healthcare benefit after 20+ years of service.

Less than 10% of the US population has served in the military. Consider that surviving WWII/Korean Veterans and Vietnam Veterans are part of that 10%, and many of that population were conscripted.
Today, military service is voluntary. Why do people who ultimately retire from the services sign up to a lifestyle that includes long separations from family, difficult living conditions in difficult locations, regular uprooting of families that impacts spousal careers and children's schooling, surrendering basic rights (if you don't show up to work, it is a crime! And add being second-guessed for decisions made while your life is in the balance), having your life disrupted over and over when you get orders for the next assignment, and of course, putting your life on the line? For 20 to 30 years?
Only 17% of those who join the add-volunteer military stay at least 20 years. The government promise is that if you are part of that 17% , you will not have to worry about health care and will receive a pension that is about equivalent to a house payment (for a house commensurate to your income).
This is the population that should have benefits cut, benefits that motivated them to stick it out?
How dare we turn to this small group of Americans who give their lives to service every day, doing whatever they are ordered to do, even if it means a shortened life or serious disability – to save a few bucks? Is it because they are a small enough group to be ignored by Congress (where only 22% of the membership has served)?
In the 1980's, cuts to military retirement benefits were implemented, which grandfathered persons who joined before the effective date of the law. Retention plummeted. In the 1990's, the original retirement system had to be restored. Can't we learn from very recent history?
Threats to this country are much greater today than what existed in the 80's. If we expect a small percentage of the population to voluntarily do their best to protect us, we must convince them that the incentives they are promised (if they live to get them) are a sacred, ironclad commitment.

There is one often overlooked fact regarding the implementation of the Tricare-For-Life program. In order to get Tricare as the secondary payer, you need to enroll and pay for Medicare Part B. The current cost for Medicare Part B is $99.90 per month. As the Medicare website dryly notes, "Higher-income consumers may pay more." "Consumers," indeed. This makes the current-year cost of my "free medical care for life" a staggering $1200 for me plus another $1200 for my wife. Yes, we were married before I joined.

I would also note that there is a tremendous amount of discussion regarding cutting retired military medical benefits…despite the "cuts" to Medicare as envisioned under Obamacare, there is no discussion of cutting actual Medicare benefits. As we learned this past August, all the federal government has to do is borrow more money to make up for this pre-planned "short-fall." Our military benefits should be inviolable but I am particularly incensed that the military is being asked to "lead the way" on deficit reduction. Please.

First, A big THANK YOU to all of you who served. I am an Army Brat and I got a lot of my shots as a kid at Walter REed, prior to WWII, my aunt, who was left mentally disabled due to childhood measles, was hospitalized at Dewitt in the '60's and the cost was $1.50 a day. This country has a debt to those who fought in WWI and other actions since, we have a debt to those who wear the uniform, PERIOD, I heard a saying, I believe goes back prior to WWI, "A country is only as stron as her Army". We have a sitting POTUS who never was in ROTC or for that matter studied the TRUE history of this country, he and his minions want to destroy what that "Stars and Stripes" stands for and, that starts with first step weaken our defense, thaen lower the moral of the whole country.

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